Testing a theoretical model: correlates of parental stress responses in the pediatric intensive care unit

Abstract

This study was designed to evaluate a theoretical framework, based on stress theory, which identifies potential sources of stress in parents of children hospitalized in an intensive care unit (ICU). The framework suggests that personal, situational, and ICU environmental stress stimuli interactively impact on the overall parental stress response. Multiple regression techniques were used to evaluate the interaction of personal family factors, situational stimuli, and ICU environmental stressors and to assess their impact upon the overall parental stress response. Data were collected from 510 parents of children hospitalized in one of five midwestern ICUs. Instruments used were the Parental Stressor Scale: Pediatric ICU (Carter & Miles, 1984), the State-Trait Anxiety Scale (Spielberger, Gorsuch, & Luschene, 1970), the Review of Life Experiences Scale (Hurst, Jenkins, & Rose, 1978), and a personal-experiential questionnaire. Results indicate that a number of personal and situational variables were predictive of higher stress. In addition two aspects of the ICU environment contributed the most variance to the overall stress of parents: alterations in the parental role and the child's behavioral and emotional responses. In evaluating the full framework, one personal variable (Trait Anxiety); two situational variables (perception of severity and type of admission); and three ICU environmental dimensions, (parental role alteration, the child's behavior and emotional response, and the child's appearance) significantly predicted stress (State Anxiety). The findings support the theoretical framework underlying this study as a useful model for studying and evaluating parental stress during a child's admission to an ICU. Results also suggest that additional personal family and situational factors, such as uncertainty, may need to be added to the model to more fully predict parental stress responses.